Before Medicating for ADHD, Check Child's Vision

By Lewis, Nancy J W | Drug Topics, March 5, 2001 | Go to article overview

Before Medicating for ADHD, Check Child's Vision


Lewis, Nancy J W, Drug Topics


What do former President Jimmy Carter, Luci Baines Johnson, Pharmacists Planning Service Inc. (PPSI), and the Tennessee Pharmacists Association have in common? All are working to raise awareness about childhood vision problems and the need for eye exams. Why? Because even though nearly 25% of school-age children have vision problems, few children receive an eye exam. Unfortunately, undetected eye disease can result in vision loss, blindness, and difficulty in learning to read and write.

The need for increased public awareness is evident in the stories of children with vision problems, such as President Carter's grandchildren and Luci Baines Johnson, who have struggled in school without being properly diagnosed and treated. My son, Jamie, is another such story. As a first grader, Jamie had excellent verbal skills but struggled to read and write. He would miss words, lose his place, skip lines, and hesitate before words like "I" and "it."

After months of unsuccessful tutoring, Jamie underwent educational testing with a child psychologist. Based on the test results, the diagnosis was attention deficit hyperactivity disorder (ADHD)-inattentive type, and medication was recommended. But the diagnosis didn't make sense to us, his teacher, others that knew him, or the child psychologist who gave us a second opinion. As parents, as pharmacists, we couldn't give him a medication without being sure of the diagnosis.

We then had an evaluation done by an occupational therapist. Occupational therapists evaluate gross and fine motor skills and provide insight into a child's learning process. I'll never forget the therapists words. "He can do things better with his eyes closed than open," she said. She then showed me a list of symptoms, most of which fit him exactly! His problem was his vision.

Why was a vision problem confused with ADHD? Here are some of the symptoms associated with vision problems: poor reading comprehension, difficulty with spelling, losing your place often while reading, getting tired quickly while reading, avoiding or postponing reading and failure to complete work on time. Obviously, the symptoms of vision problems are very similar to those of ADHD.

Jamie went on to be diagnosed by an optometrist who specializes in vision development. The exam found that he did not need glasses. However, he had difficulty keeping words in focus and making his eyes track smoothly over lines of words. In medical terms, he had convergence insufficiency and ocular motor dysfunction. So the optometrist prescribed a routine of exercises that required Jamie to consciously keep his eyes focused and moving smoothly It worked! Our son, who struggled in first grade, is now reading above grade level in second grade. …

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